COPD: Chronic Obstructive Bronchopathy under the research lens and new therapy

(by Nicola Simonetti) COPD or chronic obstructive bronchopathy, progressive lung disease, easily worsening, not completely reversible, characterized by chronic obstruction of the respiratory tract. It negatively interferes with normal breathing and affects over 384 million people in the world (3 and a half million in Italy) and is responsible for 55% of deaths from respiratory diseases, generates severe disabilities, significantly worsens the quality of life, causes premature deaths and generates economic losses (in Europe, direct costs alone exceed € 36,6 billion per year).

The main culprits are tobacco smoke (80-90% of COPD are smokers), environmental pollution and, in particular, toxic gases of many work environments (15%). In these cases, a perverse interaction between genes and the environment occurs and it is immediately a disease to be diagnosed and treated as soon as possible.

For the first diagnosis a spirometry, a non-invasive test that measures the amount of air that a person can exhale and the amount of time necessary to carry out this expiration is sufficient.

COPD is not a single disease, not a simple smoker's cough but a lung disease that gets worse over time and is life-threatening.

Main symptoms are: shortness of breath, overwhelmed, chronic cough, excessive production of phlegm, wheezing and a sense of chest tightness, progressive difficulty in making even small efforts due to lack of breath which, with the passage of time, also presents itself at rest, asthenia, weight loss.

“It is important - says prof. Antonio Spanevello (director of respiratory diseases, University of Insubria) - that the diagnosis is made as soon as possible but 6 times out of 10 it is not even suspected or placed. It is crucial to establish, once the diagnosis is made, adequate therapy, preventing exacerbations due to infectious, viral or bacterial infections with sudden worsening of respiratory symptoms such as to require medical intervention for therapy. The risk of death increases after each exacerbation: after the tithe it increases by 5 times compared to the first. The World Health Organization (WHO) announces the "Global Alliance against Chronic Respiratory Diseases, in particular, Chronic Obstructive Pulmonary Diseases". “Unfortunately - says prof. Alberto Papi (clinical director for respiratory system diseases, University of Ferrara) often the patient neglects inhalation therapy, also because the current formulations are rather difficult and require more appointments, during the day, with 2 or 3 different inhalers to use and easy mistakes of ' use. Only 29,7% of patients in the North, 26% in the Center and 23,2% in the South are compliant with the prescription ”.

It promotes adherence the new triple therapy in extrafine formulation in a single made in Italy inhaler containing: 1 steroid anti-inflammation and two bronchodilators (one direct and the other against the constriction of the bronchi). Not the do it yourself but on a medical prescription to be performed - says prof. Alberto Papi - continuously and not only when he is ill: he keeps the airway open, improves the respiratory function, avoids the inflammatory cascade connected with infections and exacerbations. Simplified therapy and accentuated efficacy.

The three active ingredients coordinate and synergize each other. The advice is: ban on active and / or passive cigarette smoking, healthier environments, habitual physical exercise; recourse to the doctor at the first symptoms, fidelity to therapy. COPD - recommends Spanevello - is vaccinated against seasonal flu.

The non-observance of medical prescriptions and the persistence of patients in smoking show that - says prof. Paola Perna, professor of communication, Sacro Cuore Catholic University, Milan - there is a void in language: between the technical terminology and the doctor's attempt to empathize with the patient there is a risk of misunderstanding. The result is patients unaware of the severity of their disease and 89% of doctors aware of the ineffectiveness of the term COPD. The invitation is to abandon the "Medichese" and make sure that the words before being said can be used to be understood.

COPD: Chronic Obstructive Bronchopathy under the research lens and new therapy

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